Renal 1 Flashcards
what organ is responsible for maintaining homeostasis in the body
kidney
renal functions (5)
- eliminated metabolic waste
- regulation of water and salts
- removal of foreign chemicals
- gluconeogenesis
- production of hormones
how does the kidney maintain balance in the body
by regulating or balancing intake with excretion
what is a primary metabolic waste that the kidney excretes
urea
what is urea
nitrogenous waste from amino acids
what salts are regulated by the kidney
Na+
Ca2+
K+
what will the kidney do if there are not enough ions (Ca2+, Na+, K+)
produce horomone 1,25 dihydroxyvitamin D
what organ is responsible for the bulk of gluconeogenesis and what part of the kidney helps that organ out with the process
the liver does most the gluconeogenesis but the cells in the cortex of the kidney help out
what is gluconeogenesis
make glucose from proteins
what three hormones do the kidney produce
erythropoietin
renin
1,25 dihydroxyvitamin D
function of erythropoietin
regulated RBC synthesis in the bone marrow
function of renin
reglate blood pressure
function of 1,25 dihydroxyvitamin D
precursor to vitamin D so important to regulate Ca2+ absorption in the intestine
explain the links between body fluid and how much fluid the kidney comes in contact with
fluid in the body is divided into extracellular fluid (33%) and intracellular fluid (67%)
extracellular fluid includes the interstitial fluid and the plasma (8% of total body fluid)
kidney only interacts with the plasma so comes in contact with very small portion of total body fluid
describe location of kidney anatomically
retroperitoneal
two main structural parts of the kidney
cortex
medulla
what is the functional unit of the kidney
nephron
what parts of the nephron are located in the medulla and in the cortex
cortex: glomerulus and beginning of tubules (proximal convoluted tubule-PCT and distal convoluted tubules-DCT)
medulla: loop of henle and collecting duct
what is the main thing that happens in the cortex of the kidney in terms of the nephron
filtration
what is the main thing that happens in the medulla of the kidney in terms of the nephron
concentrate and collect urine
describe the pathway of emptying from the nephron to the exit of the body
tubules empty into the renal pelvis which goes to the ureter which goes to the urinary bladder which goes to the urethra and exits the body
T/F: once filtration leaves the kidney in path to be excreted more absorption and secretion can occur
false; once filtration leaves the kidney nothing else can be altered
what is ESRD
end stage renal disease
what two forms exist of ESRD
chronic
Acute: shock, decrease blood pressure fast
when does hemodialysis have to be used as treatment
chronic ESRD
what is hemodialysis
blood taken from the patient’s body and filtered through exchangers, then blood is put back into the body
mimics kidney function
increasing number of patients are on dialysis
patients who have ESRD have a reduced ability to…
eliminate nitrogenous wastes
what happens when there is a build up of nitrogenous waste because the kidney cannot eliminate properly
build up of urea is converted to ammonia (can be toxic)
increase pH of oral cavity and blood
blood is alkalized
list the four manifestations of ESRD
ammonia breath: bad taste and smell in the oral cavity
gingival enlargement: drugs patient may be taking to treat renal disease may cause this
xerostomia: because pH change in mouth may inhibit proper salivary gland function
tooth problems: premature loss, narrowing pulp chambers, necrosis under crowns
two contraindications for ESRD patients
- nephrotoxic drugs should not be given
-tetracylcine
-acyclovir
-aspirin and NSAIDs
kidney will have to work too hard to eliminate these drugs causing damage - patients more susceptible to bleeding due to destruction of platelets (don’t clot well-platelet function impaired)
- poor wound healing
why is it important the nephron is only one cell wall thick
to allow for exchange between blood and fluid inside tubule
parts of a nephron
renal corpuscle:
PCT
loop of henle
DCT
collecting duct
describe renal corpuscle
glomerulus and capsule
mass of capillaries
PCT
convoluted tubule close to gomerulus
loop of henle
can be long or short
has a descending limb and ascending limb
DCT
convoluted tubule further from glomerulus
collecting duct
can be shared by several nephrons
begins in cortex and extends down through medulla
what portion of the nephron is primarily responsible for concentration of urine
loop of henle
two types of nephrons
superficial/cortical: short loop neuron
juxtamedullary: long loop neuron (glomerulus close to medulla)
why nephron type is better for concentration of urine
long loop or juxtamedullary (loop of henle is longer)
which type of nephron is more common in our body
long loop nephron
what are three main renal processes
- filtration
- secretion
- reabsorption
what is filtration and where along the tubule does it occur
moving solutes from the glomerular capillaries into the tubular fluid in bowman’s space (renal capsule)
what happens to the blood that does not filter into the renal capsule
continues onto the peritubular capillaries where can be involved in exchange with the rest of the renal tubule
what does secretion mean
when substances are transported from the peritubular capillaries into the renal tubule
what does reabsorption mean
body wants to hold onto the substance
substances are moved from the renal tubule to the peritubular capillaries
what happens to the tubular fluid that remains in the renal tubules
excreted as urine
